The role of NO system in low back pain chronicity

Low back pain (LBP) is an important interdisciplinary medical problem, in the development of which various molecular genetics, pathomorphological and pathobiomechanical mechanisms play a role. Intervertebral disc degeneration (IVDD), facet joints arthrosis and myofascial syndrome are the most important pathological processes associated with chronic lower back pain in adults. The nitric oxide (NO) system may play one of the key roles in the development of LBP and its chronicity. (1): Background: The review of publications which are devoted to changes in the NO system in patients with LBP. (2): Materials: We have carried out a search for Russian-language and English-language full-text articles published in e-Library, PubMed, Oxford Press, Clinical Case, Springer, Elsevier, Google Scholar databases. The search was carried out using keywords and their combinations. The search depth was 10 years (2011-2021). (3): Results: Role of NO and various NOsynthase (NOS) isoforms in LBP process demonstrated primarily from animal models to humans. The most studied are the neuronal NOS (nNOS). The role of inducible nose (iNOS) and endothelial (eNOS) - continues to be studied. Associative genetic studies have shown that single nucleotide variants (SNV) of genes encoding all three NOS isoforms (nNOS, NOS1 gene; iNOS, NOS2 gene; eNOS, NOS3 gene) may be associated with chronic LBP. Prospects for the use of NOS inhibitors to modulate the effect of drugs used to treat back pain are discussed. (4): Conclusion: Associative genetic studies of SNV NOS1, NOS2, NOS3 genes are important for understanding genetic predictors of LBP chronicity and development of new personalized pharmacotherapy strategies.